Endoscopic
lung volume-reduction therapy for emphysema has been associated with
therapeutic responses smaller in magnitude and less durable than surgical
volume reduction (LVRS). Bronchoscopic emphysematous lung sealant
(ELS) therapy has been shown to produce improvements in pulmonary
function similar to surgery at 1 year. This case series summarizes
safety and efficacy data of all patients from the initial ELS study
out to 2 years. Between 1 and 2 years, there were three all-cause
adverse events requiring hospitalization. One patient went on to successful
lung transplant. Improvements relative to baseline in spirometry (change
in FEV1: + 14.3 ± 33.1%; change in FVC: + 5.8 ± 23.2%)
and diffusing capacity (change in diffusing capacity of the lung for
carbon monoxide: + 10.6 ± 20.6%) were observed at 2 years.
An exponential model fit to FEV1 data at 6, 12, 18, and 24 months
predicted improvements from a baseline of &gt; 5% out to 4.1 years,
similar to what has been reported following surgery. This report confirms
long-term safety and efficacy following ELS therapy in advanced emphysema.
Studies in a larger cohort are needed to define the role of ELS therapy
in the treatment algorithm of patients with this condition.

The clinical
treatment of chronic obstructive pulmonary disease (COPD) requires
not only an improvement of airflow by bronchodilation but also the
suppression of emphysema by controlling inflammation. Here we screen
a compound library consisting of clinically used drugs for their ability
to prevent elastase-induced airspace enlargement in mice. We show
that intratracheal administration or inhalation of mepenzolate bromide,
a muscarinic antagonist used to treat gastrointestinal disorders,
decreases the severity of elastase-induced airspace enlargement and
respiratory dysfunction. Although mepenzolate bromide shows bronchodilatory
activity, most other muscarinic antagonists do not improve elastase-induced
pulmonary disorders. Apart from suppressing elastase-induced pulmonary
inflammatory responses and the production of superoxide anions, mepenzolate
bromide reduces the level of cigarette smoke-induced airspace enlargement
and respiratory dysfunction. Based on these results, we propose that
mepenzolate bromide may be an effective therapeutic for the treatment
of COPD due to its anti-inflammatory and bronchodilatory activities.

Disclaimer:
The information contained in this web site is for educational purposes only
and is not meant to replace medical advice, diagnose or treat any disease.
Your use of this site indicates your agreement to be bound.